Cochrane · systematic review · CD009311
Interventions for prophylaxis of hepatic veno‐occlusive disease in people undergoing haematopoietic stem cell transplantation
Cheuk, DKL, Chiang, AKS, Ha, SY, et al. · Cochrane Database of Systematic Reviews · 2015 · Cochrane Library
HaematologyAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
60
current version
GRADE rated
34
No studies
26
Included studies
NR
No studies 26 · 43.3%Ungraded 0 · 0%Very low 25 · 41.7%Low 9 · 15%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Summary of findings: Ursodeoxycholic acid versus placebo or no treatment
Population: People undergoing stem cell transplant with a variety of malignant and non‐malignant diseases
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of hepatic veno‐occlusive disease ( Summary of findings: Ursodeoxycholic acid vs placebo or no treatment | RR 0.6 [0.4, 0.88] | 4 studies · 612 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Overall survival ( Summary of findings: Ursodeoxycholic acid vs placebo or no treatment | HR 0.83 [0.59, 1.18] | 3 studies · 474 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
All‐cause mortality at 100 days post‐transplant ( Summary of findings: Ursodeoxycholic acid vs placebo or no treatment | RR 0.7 [0.5, 0.99] | 4 studies · 612 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Mortality attributable to hepatic veno‐occlusive disease ( Summary of findings: Ursodeoxycholic acid vs placebo or no treatment | RR 0.27 [0.09, 0.87] | 4 studies · 612 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Quality of life Summary of findings: Ursodeoxycholic acid vs placebo or no treatment | no estimate extracted | NR | No studies |
Frequency of adverse events ( Summary of findings: Ursodeoxycholic acid vs placebo or no treatment | RR 0.9 [0.37, 2.22] | 4 studies · 612 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Summary of findings: Heparin versus no treatment
Population: People undergoing autologous or HLA identical allogeneic bone marrow transplant with a variety of malignant diseases or aplastic anaemia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of hepatic veno‐occlusive disease ( Summary of findings: Heparin vs no treatment | RR 0.47 [0.18, 1.26] | 2 studies · 259 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Overall survival ( Summary of findings: Heparin vs no treatment | HR 0.65 | 1 study · 161 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
All‐cause mortality at 100 days post‐transplant ( Summary of findings: Heparin vs no treatment | RR 0.66 [0.25, 1.76] | 1 study · 161 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Mortality attributable to hepatic veno‐occlusive disease ( Summary of findings: Heparin vs no treatment | RR 0.28 [0.06, 1.32] | 1 study · 161 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Quality of life Summary of findings: Heparin vs no treatment | no estimate extracted | NR | No studies |
Frequency of adverse events ( Summary of findings: Heparin vs no treatment | RR 6.91 [0.36, 131.75] | 1 study · 161 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Summary of findings: Low molecular weight heparin versus placebo or no treatment
Population: People undergoing stem cell transplant with malignant diseases
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of hepatic veno‐occlusive disease ( Summary of findings: Low molecular weight heparin vs placebo or no treatment | RR 0.27 [0.06, 1.18] | 1 study · 45 participants | Very low Downgraded: risk of bias, imprecision |
Overall survival Summary of findings: Low molecular weight heparin vs placebo or no treatment | no estimate extracted | NR | No studies |
All‐cause mortality at 100 days post‐transplant Summary of findings: Low molecular weight heparin vs placebo or no treatment | no estimate extracted | NR | No studies |
Mortality attributable to hepatic veno‐occlusive disease Summary of findings: Low molecular weight heparin vs placebo or no treatment | no estimate extracted | NR | No studies |
Quality of life Summary of findings: Low molecular weight heparin vs placebo or no treatment | no estimate extracted | NR | No studies |
Frequency of adverse events ( Summary of findings: Low molecular weight heparin vs placebo or no treatment | RR 0.74 [0.27, 2] | 1 study · 61 participants | Very low Downgraded: risk of bias, imprecision |
Summary of findings: Defibrotide versus no treatment
Population: Children undergoing stem cell transplant with malignant and non‐malignant diseases and risk factors for hepatic veno‐occlusive disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of hepatic veno‐occlusive disease ( Summary of findings: Defibrotide vs no treatment | RR 0.62 [0.38, 1.02] | 1 study · 360 participants | Low Downgraded: risk of bias, imprecision |
Overall survival ( Summary of findings: Defibrotide vs no treatment | HR 1.04 [0.54, 2.02] | 1 study · 356 participants | Low Downgraded: risk of bias, imprecision |
All‐cause mortality at 100 days post‐transplant ( Summary of findings: Defibrotide vs no treatment | RR 1.05 [0.56, 1.97] | 1 study · 360 participants | Low Downgraded: risk of bias, imprecision |
Mortality attributable to hepatic veno‐occlusive disease ( Summary of findings: Defibrotide vs no treatment | RR 0.4 [0.13, 1.24] | 1 study · 360 participants | Low Downgraded: risk of bias, imprecision |
Quality of life Summary of findings: Defibrotide vs no treatment | no estimate extracted | NR | No studies |
Frequency of adverse events ( Summary of findings: Defibrotide vs no treatment | RR 18.79 [1.1, 320.45] | 1 study · 360 participants | Very low Downgraded: risk of bias, imprecision |
Summary of findings: Glutamine versus placebo
Population: People undergoing stem cell transplant with haematological malignancies
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of hepatic veno‐occlusive disease ( Summary of findings: Glutamine vs placebo | no estimate extracted | 1 study · 34 participants | Very low Downgraded: risk of bias, imprecision |
Overall survival Summary of findings: Glutamine vs placebo | no estimate extracted | NR | No studies |
All‐cause mortality at 100 days post‐transplant ( Summary of findings: Glutamine vs placebo | RR 0.3 [0.01, 6.84] | 1 study · 34 participants | Very low Downgraded: risk of bias, imprecision |
Mortality attributable to hepatic veno‐occlusive disease ( Summary of findings: Glutamine vs placebo | no estimate extracted | 1 study · 34 participants | Very low Downgraded: risk of bias, imprecision |
Quality of life Summary of findings: Glutamine vs placebo | no estimate extracted | NR | No studies |
Frequency of adverse events ( Summary of findings: Glutamine vs placebo | RR 2.68 [0.12, 61.58] | 1 study · 34 participants | Very low Downgraded: risk of bias, imprecision |
Summary of findings: Fresh frozen plasma versus no treatment
Population: People undergoing stem cell transplants with malignant and non‐malignant diseases
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of hepatic veno‐occlusive disease ( Summary of findings: Fresh frozen plasma vs no treatment | RR 0.66 [0.2, 2.17] | 2 studies · 383 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Overall survival Summary of findings: Fresh frozen plasma vs no treatment | no estimate extracted | NR | No studies |
All‐cause mortality at 100 days post‐transplant Summary of findings: Fresh frozen plasma vs no treatment | no estimate extracted | NR | No studies |
Mortality attributable to hepatic veno‐occlusive disease Summary of findings: Fresh frozen plasma vs no treatment | no estimate extracted | NR | No studies |
Quality of life Summary of findings: Fresh frozen plasma vs no treatment | no estimate extracted | NR | No studies |
Frequency of adverse events Summary of findings: Fresh frozen plasma vs no treatment | no estimate extracted | NR | No studies |
Summary of findings: Antithrombin III plus heparin versus heparin alone
Population: People undergoing stem cell transplant with malignant and non‐malignant diseases
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of hepatic veno‐occlusive disease ( Summary of findings: Antithrombin III plus heparin vs heparin alone | RR 0.13 [0.01, 2.15] | 1 study · 30 participants | Very low Downgraded: risk of bias, imprecision |
Overall survival Summary of findings: Antithrombin III plus heparin vs heparin alone | no estimate extracted | NR | No studies |
All‐cause mortality at 100 days post‐transplant Summary of findings: Antithrombin III plus heparin vs heparin alone | no estimate extracted | NR | No studies |
Mortality attributable to hepatic veno‐occlusive disease ( Summary of findings: Antithrombin III plus heparin vs heparin alone | no estimate extracted | 1 study · 30 participants | Very low Downgraded: risk of bias, imprecision |
Quality of life Summary of findings: Antithrombin III plus heparin vs heparin alone | no estimate extracted | NR | No studies |
Frequency of adverse events ( Summary of findings: Antithrombin III plus heparin vs heparin alone | RR 0.29 [0.04, 2.27] | 1 study · 30 participants | Very low Downgraded: risk of bias, imprecision |
Summary of findings: Heparin versus low molecular weight heparin
Population: Patients undergoing stem cell transplant with malignant and non‐malignant diseases
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of hepatic veno‐occlusive disease ( Summary of findings: Heparin vs low molecular weight heparin | RR 1.96 [0.8, 4.77] | 1 study · 93 participants | Very low Downgraded: risk of bias, imprecision |
Overall survival Summary of findings: Heparin vs low molecular weight heparin | no estimate extracted | NR | No studies |
All‐cause mortality at 100 days post‐transplant Summary of findings: Heparin vs low molecular weight heparin | no estimate extracted | NR | No studies |
Mortality attributable to hepatic veno‐occlusive disease ( Summary of findings: Heparin vs low molecular weight heparin | RR 2.94 [0.12, 70.3] | 1 study · 93 participants | Very low Downgraded: risk of bias, imprecision |
Quality of life Summary of findings: Heparin vs low molecular weight heparin | no estimate extracted | NR | No studies |
Frequency of adverse events ( Summary of findings: Heparin vs low molecular weight heparin | RR 0.84 [0.3, 2.31] | 1 study · 93 participants | Very low Downgraded: risk of bias, imprecision |
Summary of findings: Heparin versus prostaglandin E1
Population: Patients undergoing stem cell transplant with malignant and non‐malignant diseases
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of hepatic veno‐occlusive disease ( Summary of findings: Heparin vs prostaglandin E1 | RR 1.2 [0.58, 2.5] | 1 study · 94 participants | Very low Downgraded: risk of bias, imprecision |
Overall survival Summary of findings: Heparin vs prostaglandin E1 | no estimate extracted | NR | No studies |
All‐cause mortality at 100 days post‐transplant Summary of findings: Heparin vs prostaglandin E1 | no estimate extracted | NR | No studies |
Mortality attributable to hepatic veno‐occlusive disease ( Summary of findings: Heparin vs prostaglandin E1 | RR 0.5 [0.05, 5.33] | 1 study · 94 participants | Very low Downgraded: risk of bias, imprecision |
Quality of life Summary of findings: Heparin vs prostaglandin E1 | no estimate extracted | NR | No studies |
Frequency of adverse events ( Summary of findings: Heparin vs prostaglandin E1 | RR 0.43 [0.18, 1.02] | 1 study · 94 participants | Very low Downgraded: risk of bias, imprecision |
Summary of findings: Low molecular weight heparin versus prostaglandin E1
Population: People undergoing stem cell transplant with malignant and non‐malignant diseases
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of hepatic veno‐occlusive disease ( Summary of findings: Low molecular weight heparin vs prostaglandin E1 | RR 0.61 [0.24, 1.55] | 1 study · 93 participants | Very low Downgraded: risk of bias, imprecision |
Overall survival Summary of findings: Low molecular weight heparin vs prostaglandin E1 | no estimate extracted | NR | No studies |
All‐cause mortality at 100 days post‐transplant Summary of findings: Low molecular weight heparin vs prostaglandin E1 | no estimate extracted | NR | No studies |
Mortality attributable to hepatic veno‐occlusive disease ( Summary of findings: Low molecular weight heparin vs prostaglandin E1 | RR 0.2 [0.01, 4.14] | 1 study · 93 participants | Very low Downgraded: risk of bias, imprecision |
Quality of life Summary of findings: Low molecular weight heparin vs prostaglandin E1 | no estimate extracted | NR | No studies |
Frequency of adverse events ( Summary of findings: Low molecular weight heparin vs prostaglandin E1 | RR 0.51 [0.23, 1.15] | 1 study · 93 participants | Very low Downgraded: risk of bias, imprecision |